Single-port inflatable mediastinoscopic esophagectomy is a cure for esophageal cancer patients: Case report.

RATIONALE: It is often difficult to perform transthoracic esophagectomy (TTE) in patients with chest deformities, as these patients may be lost to surgery for non-oncological reasons. PATIENT CONCERNS: In this case, we had a patient with esophageal squamous cell carcinoma (ESCC) who was not suitable for TTE because of extensive thoracic adhesions caused by the left pneumonectomy 8 years ago. DIAGNOSES: ESCC. INTERVENTIONS: Based on Professor Fujiwara's surgical method, we further improved it by proposing a single-port inflatable mediastinoscopy combined with laparoscopic-assisted esophagectomy. OUTCOMES: At the time of this writing, computed tomography and gastroscopy revealed no stenosis of anastomosis, and no evidence of disease recurrence. LESSONS: To the best of our knowledge, the present case is the first single-port inflatable mediastinoscopic esophagectomy performed on a patient undergoing pneumonectomy.

Comparison of single- and triple-port VATS for lung cancer: A meta-analysis.

OBJECTIVE: To compare the perioperative parameters between single- and triple-port video-assisted thoracoscopic surgery (VATS) lobectomy in the treatment of lung cancer. METHODS: The Pubmed, Embase, Cochrane library, and the Web of Science databases were electronically searched from inception to September 2019 for all relevant studies. Study quality was evaluated using the Jadad scale or the Newcastle-Ottawa scale. The results were pooled using the generic inverse-variance method and expressed as mean differences or risk ratios, with 95% confidence intervals. RESULTS: Three randomized controlled trials (RCTs) and ten cohort studies with 2,278 subjects were included in the meta-analysis. Whether based on RCTs or cohort studies, the pooled results showed no significant difference in the operation time, chest tube duration, intraoperative blood loss, postoperative hospital stays, lymph node dissection number, postoperative drainage volume, and postoperative complications between single- and triple-port VATS lobectomy (P > 0.05). Single-port VATS could relieve postoperative pain better than triple-port VATS, especially in the first day and fifth day (P < 0.05). No evidence of significant publication bias was found (P > 0.05). CONCLUSION: Single-port VATS lobectomy can yield similar perioperative results to those of triple-port VATS lobectomy and is more effective in relieving postoperative pain.

Two-stage S7 sleeve resection of the right lower lobe and S1+2 and S3 segmentectomy of the left upper lobe: a case report.

Synchronous multiple nodules in the lungs, such as peripheral ground-glass opacities (GGOs) and solid small nodules, are common, but only lesions suspected of being malignant should be surgically removed. The surgical strategy is anatomical sub-lobectomy in early stage of non-small cell lung cancer synchronously or asynchronously to decrease the impact of lung resection on the lung function. Here, we report a case of a 56-year-old man, who was a pack-a-day smoker, with endobronchial hamartomas the medial basal bronchus (B7). The patient underwent sleeve resection of the medial basal segment in the right lower lobe, followed by S1+2 and S3 segmentectomy because of early-stage lung adenocarcinoma (T1a), which presented as mixed GGOs located in the left upper lobe. The performance of S7 sleeve segmentectomy of the RLL is very rare. The main concern is stenosis of the anastomosis and the major technical striking point is the caliber discrepancy between proximal and distal bronchi. In our experiences, we used high-tech methods as three-dimensional reconstruction to provide a basis for our surgical planning and proper patient selection and a series of preventing measures taken for anastomotic stenosis, successfully avoided complications. This case provides a new strategy for the treatment of patient with multiple early-stage lung cancer and benign endobronchial tumors, simultaneously.